Webinars and Presentations
Previous MetaLab Webinars
Lessons from the Field
Presenters: Jeremy Grimshaw, Samantha Hamilton, Nicola McCleary, Nicole Etherington
Webinar date: August 20, 2020
Summary: This webinar focuses on using audit and feedback to improve the use of personal protective equipment (PPE) for healthcare professionals. Samantha Hamilton, Director of Quality and Patient Safety at The Ottawa Hospital, discusses their ongoing efforts with PPE usage and Dr. Nicola McCleary tells us how the research team from the Ottawa Hospital Research Institute provided their support. Dr. Nicole Etherington speaks about another PPE related initiative ongoing at The Ottawa Hospital. Given the ongoing COVID pandemic, this topic will be of interest to those in all spectrums of healthcare and research.
Presenter: Jane London
Webinar date: December 10, 2020
Summary: Jane London, the Design and Innovation Manager at NPS MedicineWise in Australia has the job of trying to make audit and feedback work at a national scale. NPS MedicineWise is a behaviour change organisation focused on best practice use of medicines and medical tests. They work across primary and hospital settings with a range of audiences, such as family doctors, specialists, pharmacists and consumers of health care.
Within their national programs, NPS MedicineWise has designed and implemented a range of different audit and feedback interventions for various audiences and knows the pain of trying to get these things to work in the real world. Jane will share with you some of her insights in how you work with teams and clinicians to get audit and feedback happening in practice. In particular, examples from how she has used outcomes from A&F conferences to marry best practice evidence with the ins-and-outs of A&F development.
Presenters: Ivana Goluza Riddell & Marina Sarkis
Webinar date: February 9, 2022
Summary: Ivana Goluza Riddell (Clinical and Organisational Systems Auditor) and Marina Sarkis (Network Manager Diabetes and Endocrine) work at the NSW Agency for Clinical Innovation (ACI), a lead agency for innovation in clinical care in NSW.
Audit and Improvement has supported the remit of the organisation by identifying clinical variation for improvement and supporting implementation and innovation work. ACI brings together clinicians, managers and consumers across NSW and Marina and Ivana will describe how the program supports clinical network-led, state-wide improvement initiatives.
Ivana will discuss how the program aims to incorporate best practices in A&F as well as resulting challenges and opportunities. Marina will share the context, lessons learnt from the state-wide Inpatient Management of Diabetes Mellitus audits; local and state-wide solutions for improvement and how this will translate to the next tranche of state-wide Inpatient Management of Diabetes Mellitus audits.
Presenter: Dr. Lara Cooke
Webinar Date: April 21, 2022
Summary: Audit and feedback intervention studies frequently focus on providing feedback using passive data report cards or in one-on-one settings. However, audit and feedback interventions may be strengthened using social interaction. The Calgary office of the Alberta Physician Learning Program has developed audit and group feedback for physicians.
Dr. Lara Cooke, former Associate Dean of Continuing Medical Education, a neurologist and head of the section of Neurology at the Cumming School of Medicine in Calgary, Alberta, Canada, will present findings from research around the design and outcomes of a program using the Calgary Audit and Feedback Framework.
More details about the study can be found in these publications:
Presenter: Dr. Nick Daneman
Webinar Date: June 21, 2022
Summary: Dr. Nick Daneman is a Clinician Scientist and Division Head of Infectious Diseases at Sunnybrook Health Sciences Centre (located in Toronto, Ontario, Canada), is cross-appointed in the Institute of Health Policy Management and Evaluation at the University of Toronto, and is an Adjunct Scientist at the Institute for Clinical Evaluative Sciences and Public Health Ontario. Using hospital, clinical trial, and population-based data sources, his research program aims to maximize the benefits while minimizing the harms of antimicrobial treatment.
In this webinar, Dr. Daneman will present the results of a province-wide peer comparison audit and feedback program to antibiotic prescribers in long term care facilities, including two randomized controlled trials comparing incremental improvements to audit and feedback.
Presenter: Professor Tim Shaw
Webinar Date: September 13, 2022
Summary: Professor Tim Shaw will describe a practice analytic program across five private hospitals in Australia and the Colleges of Surgeons and Physicians. This analytic program looks at how teams make sense of health data and how this can be used in clinical settings to support reflection and practice change as well as link to professional development requirements.
Tim is the Professor of Digital Health and Director of the Research in Implementation Science and eHealth Group (RISe) in the Faculty of Medicine and Health at the University of Sydney. Tim has led an active research and development team at the University of Sydney since 2000 that has focused on implementation science. His current focus is on how we use health data to impact on clinical decision making, quality improvement and professional development.
Ivana Goluza Riddell the Audit and Feedback lead at the NSW Agency for Clinical Innovation will chair the session.
Research in Progress
Presenters: Dr. Kevin Schwartz & Dr. Noah Ivers
Webinar date: October 22, 2020
Summary: Audit and feedback is an effective strategy that helps clinicians have an understanding of ordering patterns in comparison to their peers. This can help drive change and improve health outcomes for all. This webinar highlights recent efforts to conduct and evaluate large-scale audit and feedback initiatives in Ontario, including a completed trial involving 3500 primary care physicians. Drs. Schwartz and Ivers also highlight future plans to expand this trial and put the findings to date into context of the broader literature.
This webinar was cohosted by the CWC De/Implement series and the Audit & Feedback Metalab.
Presenter: Dr. Sarah Alderson
Webinar date: January 21, 2021
Summary: There are potential significant returns on investment from participation of existing clinical audit programmes in coordinated programmes of research to improve effectiveness. Interviews were conducted with feedback researchers, clinical audit staff and healthcare professionals in receipt of audit programmes.
The optimal conditions for sustainable collaboration between clinical audit programmes and feedback researchers includes resources, logistics, leadership and relationships. Perceived risks of embedded experiments in clinical audits include alienating end users and fears of jeopardising future recommissioning with ‘negative’ experiments. Overall, all participants felt the benefits of participation outweighed the risks. Sarah will share with you the ten top tips for successful collaborations between audit programmes and feedback researchers.
Presenters: Dr. Denise O’Connor & Jade Ting
Webinar date: April 22, 2021
Summary: In many countries, including Australia, Audit and Feedback programs are used by healthcare organisations to promote the uptake of research findings into practice and improve healthcare quality. However, little is known about how they are designed and delivered and the extent to which they are informed by empirical and theoretical knowledge about how audit and feedback works and how its effects could be enhanced.
In this ‘Research in Progress’ talk, Denise and Jade will present their findings on the design and delivery characteristics of national Audit and Feedback programs in Australia collected in an online survey and document analysis in 2020.
Presenter: Dr. Sylvia J. Hysong
Webinar date: May 13, 2021
Summary: Dr. Sylvia Hysong will present the recently published study of the REFLECT intervention. (https://bjgpopen.org/content/bjgpoa/5/2/BJGPO.2020.0185.full.pdf). This work was centered around improving team coordination in primary care using audit and feedback. The primary aim was to implement and evaluate the sustainability of a multifaceted intervention comprising team-based audit-and-feedback with debrief. Conducted as a case-control trial within the US Veterans Health Administration medical centres, we will hear the results of this study and the impact of the COVID-19 pandemic on intervention sustainability.
Sylvia J. Hysong, Ph.D. is a Lead Research Scientist at the Center for Innovations in Quality, Effectiveness and Safety (IQuESt, a Center of Innovation sponsored by the U.S. Department of Veterans Affairs Health Services Research and Development Service), Professor of Medicine at the Baylor College of Medicine, and Alumni Affairs Director for the VA Quality Scholars Program Coordinating Center.
She is an industrial/organizational psychologist with two decades of experience in organizational research and quality improvement implementation. Funded currently by the Department of Veterans Affairs Health Services Research & Development Service (VA HSR&D) and the Agency for Healthcare Research & Quality, her research interests include primary health care as a work environment, feedback systems, team coordination, and performance measurement.
Presenters: Alex Wright-Hughes, Dr. Tom Willis, Professor Robbie Foy
Webinar date: October 14, 2021
Summary: Audit and feedback aims to improve patient care by comparing health care performance against explicit standards. It is used to monitor and improve patient care, including through National Clinical Audit (NCA) programmes in the United Kingdom. Variability in effectiveness of audit and feedback is attributed to intervention design; separate randomised trials to address multiple questions about how to optimise effectiveness would be inefficient. We evaluated different feedback modifications to identify leading candidates for further ‘real world’ evaluation.
Using an online fractional factorial screening experiment, we randomised recipients of feedback from five UK NCAs to different combinations of feedback modifications. Outcomes, assessed immediately after participants were exposed to the online modifications, included intention to enact audit standards, comprehension, user experience, and engagement. This design allowed us to explore single effects of feedback modifications, and synergistic and antagonistic effects across combinations of feedback modifications, audit programmes and recipient.
Best Practices in Audit & Feedback
Presenters: Jamie Brehaut, Noah Ivers
Webinar date: September 24, 2020
Summary: This webinar introduces us to audit and feedback and provides suggestions of how best to implement it to improve practice. It then talks about the Audit & Feedback MetaLab and how it can be helpful to your implementation work. This webinar is helpful for those new to the world of audit and feedback or implementation science, or anyone hoping to refresh their knowledge on the subject.
Presenters: Zach Landis-Lewis
Webinar date: February 18, 2021
Summary: Audit and feedback commonly involves visual displays, including charts and tables, in the delivery of clinical performance summaries to providers and teams. Visual displays can strongly moderate the successful interpretation of quantitative information, but our understanding of factors affecting the use of visual displays in audit and feedback is limited. In this research-in-progress talk, we use insights from cognitive science and an analysis of visual displays in audit and feedback to consider what factors are likely to matter most, including those related to the feedback recipient, their context, and the visualization itself.
Audit & Feedback Presentations
Presenters: Drs. Laura Desveaux, Noah Ivers & Nicola McCleary
12th Annual Conference on the Science of Dissemination and Implementation in Health
Presenters: Drs. Jeremy Grimshaw & Noah Ivers
Society for Implementation Research Conference – September 12-14, 2019
Presenter: Dr. Noah Ivers
KT Canada Seminar Series – September 14, 2017
Society for Clinical Trials 39th Annual Meeting 2018
Implementation science can be defined as the “study of theories, process, models and methods of implementing evidence-based practice in healthcare”. Implementation interventions (e.g. audit and feedback) are complex. When two-arm trials have shown that, in general, an intervention package is effective, the next logical step is to establish whether a particular version of that intervention is effective and if this generalizes across settings. The large number of different potential versions of a complex intervention, means that it is likely that a series of trials will be needed to identify the optimal intervention. Implementation laboratories have recently been proposed as a way of utilising existing large-scale service implementation programmes (e.g. national clinical audits) to embed sequential randomised trials that would test different ways of delivering implementation interventions in comparisons at scale. Implementation laboratories involve healthcare system partners in continuous improvement using rigorous methods to identify more effective variants of an intervention that can be routinely and sustainably embedded into their ongoing programs. However, the opportunity of conducting a series of linked large-scale pragmatic trials on similar samples of healthcare providers also raises challenges.
It is therefore important that a range of design choices are considered for randomised trials conducted within these laboratories. Some of these have been used in this context, while others are more typically used elsewhere and need adapting for this purpose. The aim of this session is to provide an overview of a number of possible trial designs, bringing together methodologists from diverse backgrounds to discuss the priorities going forward.
Presenter: Dr. Jeremy Grimshaw
Abstract: This talk will provide an overview of an example of an implementation laboratory for audit and feedback interventions, providing a description of the motivation for establishing implementation laboratories and their potential for moving a field forward. The design challenges associated with conducting a series of trials will be introduced.
Presenter: Dr. Monica Taljaard
Abstract: This talk will summarise the trial designs that are currently used in this context, providing examples, highlighting their limitations and raising points for discussion.
Presenter: Dr. Shawna N. Smith
Abstract: This talk will provide an overview of trial designs used to optimise an intervention that dynamically evolves over time. While these are typically used to optimise patient-level interventions, consideration will be given to how they may be extended to optimise healthcare provider level interventions common in implementation science.
Presenter: Dr. James Wason
Abstract: This talk will provide an overview of a specific type of adaptive design that, over time, includes decisions to drop existing, or include new, interventions from an ongoing trial. While these are typically used to evaluate pharmacological interventions, consideration will be given to how they may be extended to evaluate complex interventions.
Presenter: Dr. Amanda Farrin
Abstract: This will first summarise the key themes from the previous talks and outline the future priorities based on these. The discussant will then lead a discussion, including speakers and those attending the session, on these priorities.
Presenter: Dr. Sylvia Hysong
May 5, 2022
Summary: Audit and feedback is an implementation strategy that can encourage professionals to change their clinical practice by providing a systematic review of professional performance based on explicit criteria or standards. This information is subsequently fed back to professionals in a structured manner. This webinar will present the theory and science best practice in audit and feedback design, present key contextual factors driving feedback effectiveness, and recommendations for optimizing the design of audit and feedback to improve quality of care.